摘要目的 评价彩色多普勒超声对布鲁菌病(简称布病)睾丸炎的临床诊断价值.方法 采取前瞻性设计及病例对照研究方法,选择2014-2016年黑龙江省农垦总局总医院确诊并收治住院的布病睾丸炎患者作为病例组,以同期来医院体检的健康人作为对照组.应用彩色多普勒超声测量并比较两组人群双侧睾丸大小,实质回声,实质内血流信号,鞘膜腔积液最大深径,睾丸动脉收缩期峰值流速(PSV)、舒张末期流速(EDV)、搏动指数(PI)、阻力指数(RI)、收缩期峰值流速/舒张末期流速(S/D).结果 共选择病例组62人,对照组41人.病例组睾丸体积与对照组比较差异无统计学意义(cm3:15.81±3.27比15.82±2.77,t=0.015,P＞0.05).病例组病程与睾丸体积呈负相关(r=-0.594,P＜0.01).病例组睾丸鞘膜腔积液深径高于对照组(cm:1.50±0.53比0.84±0.21,t=10.777,P＜0.01),睾丸动脉PSV和EDV均高于对照组(cm/s:9.73±3.25比6.00±1.38、2.89±0.77比2.46±0.36,t=9.810、4.691,P均＜0.01).病例组睾丸动脉PI、RI均高于对照组(1.06±0.12比0.82±0.08、0.69±0.05比0.58±0.04,t=15.678、12.763,P均＜0.01).结论 布病睾丸炎患者的血流频谱、睾丸鞘膜腔积液深径均呈特异性变化,彩色多普勒超声能够有效评估布病睾丸炎患者的睾丸损伤情况,为临床治疗提供可靠的影像学依据.

abstractsObjective To evaluate the clinical diagnostic value of color Doppler ultrasound in diagnosis brucellosis with orchitis.Methods Hospital-based case-control study was used.We selected the patients with brucellosis orchitis who were hospitalized in Heilongjiang Land Reclamation Bureau General Hospital from 2014 to 2016 as a case group.At the same time,selected healthy people as the control group.Bilateral testicular size,parenchyma echo,flow signals in parenchyma,depth of bilateral testicular sheath membrane cavity effusion,testicular artery peak systolic velocity (PSV),end-diastolic velocity (EDV),pulsatility index,resistance index,peak systolic velocity/end-diastolic velocity,were measured and analyzed using color Doppler ultrasound.Results The case group included 62 patients;the health control group included 41 persons.The testicular volume of case group was compared to that of healthy control group,there was no statistical significant difference (cm3:15.81 ± 3.27 vs 15.82 ± 2.77,t =0.015,P ＞ 0.05).By analyzing the correlation between the course of the disease and the testicular volume,a negative relationship was found (r =-0.594,P ＜ 0.01).In the case group,the deep diameter of the testicular sheath was higher than that of the healthy control group,and the difference was statistically significant (cm:1.50 ± 0.53 vs 0.84 ± 0.21,t =10.777,P＜ 0.01).The PSV and EDV were higher than those in the control group (cn/s:(9.73 ± 3.25 vs 6.00 ± 1.38,2.89 ± 0.77 vs 2.46 ± 0.36,t =9.810,4.691,P ＜ 0.01).The pulsation index and resistance index were higher than that in the control group (1.06 ± 0.12 vs 0.82 ± 0.08,0.69 ± 0.05 vs 0.58 ± 0.04,t =15.678,12.763,P ＜ 0.01).Conclusions There are specific changes in Brucella patients with orchitis.The blood flow spectrum and testicular sheath membrane cavity effusion are specific changes.The color Doppler ultrasound can effectively evaluate Brucella orchitis patients with testicular injury,provide a reliable imaging basis for clinical treatment.